Biomedical Engineering Reference
In-Depth Information
The ability to distinguish between different types of tissue in the body is of vital
importance to a surgeon. Before making an incision into tissue, the surgeon must first
identify what type of tissue is being incised, such as fatty, muscular, vascular, or nerve tis-
sue, since failure to classify this correctly can have severe repercussions. For example, if a
surgeon fails to properly classify a nerve and cuts it, the patient may suffer effects ranging
from loss of feeling to loss of motor control. The identification and classification of differ-
ent types of tissue during surgery, and more importantly during a cutting procedure, will
necessitate the creation of smart surgical tools. One major approach to developing such
tools is retrofitting existing surgical tools, instead of developing new and revolutionary
ones. The advantage of this is due to the fact that newly designed surgical tools are subject
to the strictures of regulatory control bodies, such as the Food and Drug Administration
(FDA) and the European Community (EC), under whose auspices approval could take any-
where between 5 and 15 years [13]. Therefore, retrofitting current surgical tools is prefer-
able and, in any event, these modified tools have already been used by surgeons and who
are, therefore, familiar with their applications. Furthermore, the cost involved in clinical
trials for such retrofitted tools can be either avoided altogether or at least greatly reduced.
In conclusion, smart endoscopic tools are a prerequisite to enhancing and facilitating the
performance of currently available MIS procedures and robotic surgery. Further develop-
ment of MIS tools is required, as is the necessity to expand upon our existing knowledge
and research into the industrial aspects of robotic surgery.
1.3 Motivation
Minimally invasive procedures are growing rapidly. Presently, 40% of all surgeries are
performed in this manner and this will rise to 80% by end of the decade [14]. However,
despite the many advantages of MIS and MIRS (minimally invasive robotic surgery) over
conventional surgery, their main drawback is the almost complete lack of a sense of
touch. Even the only FDA-approved robots (Da Vinci™ from Intuitive Surgical Inc. and
Zeus from Computer Motion Inc.) suffer from this lack of haptic feedback and the latest
and most modern system, the Amadeus Robotic Surgical System from Titan Medical Inc.
(which is planned for release in 2012) benefits from only force feedback capabilities.
Teletaction systems generally comprise three key elements, namely: a tactile sensor array,
a tactile filter (processing, conversion, and control algorithms), and a tactile display.
The tactile sensor array collects comprehensive information about the contact zone. This
information is then processed using a tactile filter and the control signals are then passed
to a tactile display which is able to mimic softness, roughness, and texture in a static
and dynamic way. Therefore, restoring the lost tactile perception has been the motivating
factor in several recent research works, including this topic. In addition to the introduction
of an innovative multifunctional tactile sensor that can be integrated into conventional MIS
tools, exploring the potential capabilities of such sensors in terms of force measurement,
force position sensing, and softness sensing is of high importance. Another challenging
problem in this area is the development of methodologies for processing and converting
the data gathered by tactile sensors into a useful format for surgeons. In this regard, several
attempts have been made to develop different kinds of tactile displays. The complexity
of the mechanical tactile displays provided the motivation for introducing a scheme in
which the tactile information is graphically presented to the surgeon.
